Individual provider Active NPI

Tara Sue Pratt, DC

  • Chiropractor
  • Bettendorf, IA
National Provider Identifier
1891763900
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06817 Issued in IA
Practice address
1900 State St
Suite 2
Bettendorf, IA 52722-5195
Phone
(563) 323-1551
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 06817 IA Primary

Addresses

Primary practice location

1900 State St
Suite 2
Bettendorf, IA 52722-5195

Mailing address

1900 State St
Suite 2
Bettendorf, IA 52722-5195
Phone (563) 323-1551

Other identifiers 1

IdentifierTypeStateIssuer
39899OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050915001230 IA Practitioner - Chiropractic 5193758415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3048 Victoria St
Bettendorf, IA 52722-2793
Phone (563) 323-1551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06817IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Midway Chiropractic LLC Chiropractor CurrentSince Aug 1, 2008 Accepting new patients
A Better Life Chiropractic and Wellness PLLC Chiropractor Past Accepting new patients
Midway Chiropractic Clinic Chiropractor Past Accepting new patients

Locations

2021 Highway 130
Bennett, IA 52721
Phone (319) 430-4388

1900 State St
Ste 2
Bettendorf, IA 52722
Phone (563) 323-1551

3048 Victoria St
Bettendorf, IA 52722
Phone (563) 323-1551

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1891763900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 STATE ST",
            "address_2": "SUITE 2",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527225195",
            "telephone_number": "563-323-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 STATE ST",
            "address_2": "SUITE 2",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527225195",
            "telephone_number": "563-323-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "TARA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "39899",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.